The medical system in this country is totally fucked.

[ArtieChokePhin]

I was wrong about the bill.  $4000 wasn't the cost of everything -- it was only the cost of the service.

The actual bill was $34,000.


To essentially get turned away.  I'm getting an itemized bill but I think the CT scan probably cost $20,000.

And that's another issue.   Why is a CT scan $20,000?

[Tenshot13]

So do you have to pay $34k or is your insurance covering some of it and that's the total charge?  My wife and I had our first kid a few months back and we were in the hospital for 3 days, it didn't cost this much total before insurance kicked in.

[Spider-Dan]

And that's another issue.   Why is a CT scan $20,000?

Because there is no one in our for-profit healthcare system with a vested interest in containing healthcare costs, which is why healthcare costs far more in the US than in any other country.

In other countries where the government pays for healthcare, there are auditors who challenge medical providers when they claim crazy costs for services, because those services are paid for by taxes and voters are extremely aware of who to blame when taxes go up (politicians).  But here, insurance companies don't care; they simply pass the costs on to the insured, and when health insurance premiums go up, people still blame politicians instead of blaming the healthcare insurance companies or the medical industry.

There is, of course, one prominent counter-example to the idea of government keeping costs down that many people are familiar with: the military.  I'm sure plenty of ex-military on this forum can regale us with tales of $40 screws or $2000 shelves.  And the reason for that is simple: there is no constituency in this country for controlling the costs of our military, so the exact same dynamic applies for the military as it does for private healthcare insurance companies.

[Fau Teixeira]

Health insurance is the single most worthless industry ever conceived.  There's a 100% usage rate, everyone at some point needs health care. It's not optional, and there's no competition. It's the worst industry ever conceived of, only surpassed historically by the tobacco industry.

[Dave Gray]

So do you have to pay $34k or is your insurance covering some of it and that's the total charge?

I certainly don't have to pay $34K myself out of pocket.  But the fact that that's getting charged anywhere is a scam -- the rates are unsustainable and it's getting paid by everyone.  They're ripping it off of somewhere.

But I'll probably end up paying 8K or something nuts, unless I can dispute it.  I have to get an itemized list.

[Downunder Dolphan]

Just shaking my head at just how bad that is over there compared to this corner of the world, and in so many ways...

Around 25 years ago I also had a bad episode with a kidney stone at about 4am in the morning in the same sort of pain Dave is describing. My brother took me to the public hospital where I was quickly admitted to a cubicle in emergency, examined and shot up shot up with Pethidine, and diagnosed with the problem (I think a urine test which had blood in the sample confirmed it) and was released that same day with an appointment to see a urologist plus a follow up IVP test to determine the size and position of the stone. No charge, apart from the cost of the pain relief tablets I was supplied by the hospital chemist to get me through to the specialist appointment and test (which were a LOT stronger than Advil).

Just over 10 years ago I had a tumor, and as part of the follow up I had to have CT scans with contrast for five years to make sure it did not return (at first every month, then every six months, then every year). Full cost for each one up front was about AUD $900 per scan, after Medicare it ended up being about $140 out of pocket each time. Allowing for medical inflation (which is always a LOT more than regular inflation) I wouldn't expect the full cost to be more than AUD $2-3K now before any subsidy... which would be probably around USD $1400-1700 each.

It's shocking that Dave was stuck in the waiting room - yet charged like a wounded bull as an admitted patient (with a decided lack of patient care). There's no way that would happen here, no matter how overloaded the hospitals are (and they are also struggling here right now with both Covid and Flu admissions during our winter). Arranging a CT scan may be a thorough diagnostic tool, but seems overkill considering the situation - and then there's the cost: USD $20K!!! My jaw dropped at that!

We have a bit of a two tiered system here - yes there is a basic universal healthcare for emergency procedures at public hospitals, and most GP visits. But if you earn over a certain amount you are taxed higher to encourage you to take out private health insurance. If you wait until after you turn 30, the cost of doing it increases, which again encourages people to pay for it before then. Non essential elective surgery (like knee or hip surgery) either has a typical waiting time of years to be eligible for free treatment, or you pay top dollar to have it done immediately through the private system - unless you have private health insurance which covers most (if not all) the cost. It ain't perfect, but it's a hell of a lot fairer and a lot better than what it sounds like in the USA.

Dave, depending on the size and position of the kidney stone, you will likely be given a couple of choices. If it's small enough you will be given a couple of weeks to drink a lot of water and piss it out (like I did) or the urologist will stick a probe up... you know where, to retrieve it (thankfully I pissed it out before then). If it's a large stone like my father once had, they can bombard it with ultrasound to break it up, and then it will come out in your urine like fine gravel. From what you described about your medical system over there, that could cost you $$$

Once you go through an experience like this you will never forget it, and you will pick the causes and warning signs - and then start upping your water intake. Usually it's do to lots of calcium and acid in the diet - and sometimes things you don't think of, like regular taking of Vitamin C tablets for years. The first signs are blood in the urine which you can pick by the darker color and really funky, pungent smell (to me it smells like an orange and passionfruit juice mix). Once you smell that and/or getting a few pains in the back, it's time to hit the water...

All I can say is welcome to the club Dave - and rest easy, it hurts like a bitch but it's not fatal and can be manageable. Good luck!

[Sunstroke]

OK, I've held off from publicly talking about my health, but this thread (and the experience that Dave has detailed here) is sort of bringing it out...

I am a military veteran. I did 6-1/2 years in the Army during the cold war, breaking code from Soviet spetsnaz units in Eastern Europe. I have been out a very, very long time...1987 was my ETS (end tour of service). I am now 58 years old.

I was diagnosed about 4 years ago with extremely high blood pressure during an exam for an injured knee... 215/125. The FL hospital even made me sign an AMA (against medical advice) waiver before they let me leave, because as the doctor said "You could have a stroke walking out the door."  My general medical philosophy at the time was the same as it had always been..."rub some dirt on it, walk it off."

Well, that shit didn't really work.

Fast-forward 3-1/2 years to January of this year, and my problems turned serious. I started experiencing symptoms of vertigo, loss of muscle strength and swelling of my extremities. I was also having this little problem of "help I've fallen, and I can't get up!" After a couple of months of this (Did I mention I was an idiot?), I finally checked myself into a hospital. The diagnosis...severe kidney failure, and after tests, several aneurysms on my aortas. I spent 9 days in the hospital, the first two days, mostly unconscious and (according to the doctors) very near to death. I was put on all sort of medicine and had around the clock testing and monitoring. I literally woke up two days later to find my mother (my "emergency medical contact) sitting in tears at the foot of my hospital bed, praying for my survival. She had driven down from South arolins "just in case."

I was released by the hospital once they got my BP down to a semi-reasonable level (which for me was 180ish over 90-something). They prescribed a period of "home care nursing," and I came to an agreement with my family that I would move from Florida to my original home of Northern Arizona (Prescott)and stay with my sister (who had a background of healthcare and nutrition) who also had an easily schedulable job (world class photographer), so she could make sure I got to all my med appointments. She also lived very near a very large VA facility, which I qualified for, due to my former military status. At this point, I could barely walk with the use of crutches, and my medication intake was about 22 pills a day of various BP meds and other stuff.

Since I arrived in AZ in March, I have had 3 months of regular medical appointments with the VA, and many treatments/consultation appointments with non-VA specialists that were referred by the VA. I also have had 2-3 times a week physical therapy sessions and appointments, including MRI's and CT scans.

Getting to the point... The total cost of my 9 days in a FL hospital came to $8,713. I had Cigna insurance through the Obamacare care program. My cost since moving to AZ and having my treatment run through the VA...including the abnormal amount of prescriptions:  $254. Yes that is two hundred and fifty four dollars.

I recently had an ultrasound that revealed that I had a large cancerous mass on my right kidney, and that one of my aneurysms had expanded to the point where I will likely need to have both surgically removed. From what I have been told from my veteran's advisor, this will be done at virtually no cost.

Medically, I count myself blessed, as there would have been no way I could afford the mammoth amount of medical costs associated with my situation had I not been with the VA.

[Spider-Dan]

Sorry to about your medical issues, Sunstroke (and Dave, as well).
Hope you both have the best recovery you can.

[Dave Gray]

I'm just floored that essentially 3 tests from a hospital waiting room costs anyone (whether I pay it or some insurance carrier does) $34K.

That's broken.

I fully support socialized medicine.  This system is so dumb.

[Sunstroke]

I'm just floored that essentially 3 tests from a hospital waiting room costs anyone (whether I pay it or some insurance carrier does) $34K.

That's broken.

I fully support socialized medicine.  This system is so dumb.

I was floored when I read about your situation, and my sister (who really-really knows much more about medical insurance than I) was left shaking her head.

I definitely agree with the socialized medicine opinion. After nearly 60 years, experiencing the world in so many areas, the two words I keep coming to describe my beloved US of A are "corruption" and "greed."

[Brian Fein]

I'm just floored that essentially 3 tests from a hospital waiting room costs anyone (whether I pay it or some insurance carrier does) $34K.

That's broken.

Its broken because the hospital knows no one is paying that bill.  The insurance company "negotiated rate" is around 20% of the cost, so the actual bill that they pay on your behalf for that test is probably around $4k.  Your EOB should outline the actual money paid.  I believe the unregulated and innsane expenses of these are artificially inflated because of this "negotiated rate" - like when you sell list something for sale on Facebook Markeplace for double your real price, knowing you're going to get low-ball offers.

[dolphins4life]

OK, I've held off from publicly talking about my health, but this thread (and the experience that Dave has detailed here) is sort of bringing it out...

I am a military veteran. I did 6-1/2 years in the Army during the cold war, breaking code from Soviet spetsnaz units in Eastern Europe. I have been out a very, very long time...1987 was my ETS (end tour of service). I am now 58 years old.

I was diagnosed about 4 years ago with extremely high blood pressure during an exam for an injured knee... 215/125. The FL hospital even made me sign an AMA (against medical advice) waiver before they let me leave, because as the doctor said "You could have a stroke walking out the door."  My general medical philosophy at the time was the same as it had always been..."rub some dirt on it, walk it off."

Well, that shit didn't really work.

Fast-forward 3-1/2 years to January of this year, and my problems turned serious. I started experiencing symptoms of vertigo, loss of muscle strength and swelling of my extremities. I was also having this little problem of "help I've fallen, and I can't get up!" After a couple of months of this (Did I mention I was an idiot?), I finally checked myself into a hospital. The diagnosis...severe kidney failure, and after tests, several aneurysms on my aortas. I spent 9 days in the hospital, the first two days, mostly unconscious and (according to the doctors) very near to death. I was put on all sort of medicine and had around the clock testing and monitoring. I literally woke up two days later to find my mother (my "emergency medical contact) sitting in tears at the foot of my hospital bed, praying for my survival. She had driven down from South arolins "just in case."

I was released by the hospital once they got my BP down to a semi-reasonable level (which for me was 180ish over 90-something). They prescribed a period of "home care nursing," and I came to an agreement with my family that I would move from Florida to my original home of Northern Arizona (Prescott)and stay with my sister (who had a background of healthcare and nutrition) who also had an easily schedulable job (world class photographer), so she could make sure I got to all my med appointments. She also lived very near a very large VA facility, which I qualified for, due to my former military status. At this point, I could barely walk with the use of crutches, and my medication intake was about 22 pills a day of various BP meds and other stuff.

Since I arrived in AZ in March, I have had 3 months of regular medical appointments with the VA, and many treatments/consultation appointments with non-VA specialists that were referred by the VA. I also have had 2-3 times a week physical therapy sessions and appointments, including MRI's and CT scans.

Getting to the point... The total cost of my 9 days in a FL hospital came to $8,713. I had Cigna insurance through the Obamacare care program. My cost since moving to AZ and having my treatment run through the VA...including the abnormal amount of prescriptions:  $254. Yes that is two hundred and fifty four dollars.

I recently had an ultrasound that revealed that I had a large cancerous mass on my right kidney, and that one of my aneurysms had expanded to the point where I will likely need to have both surgically removed. From what I have been told from my veteran's advisor, this will be done at virtually no cost.

Medically, I count myself blessed, as there would have been no way I could afford the mammoth amount of medical costs associated with my situation had I not been with the VA.

Can I get some clarification?

Was that Florida bill before or after insurance?

Why does the va not apply down in Florida?

If you didn’t get help through the va, what would the Cigna bill have been in Arizona?

Hope everything gets better

Stupid iPhone messes my words up

Had to edit this post twice

My apologies

[Sunstroke]

Can I get some clarification?

Was that Florida bill before or after insurance?

I have asked Cigna and Boca West Hospital that same question multiple times. I haven't gotten any answer that is clear. They simply send me the same bill over and over.

Why does the va not apply down in Florida?

I'm sure it would have, but I never went to the VA in Florida

If you didn’t get help through the va, what would the Cigna bill have been in Arizona?

No idea, but I did find out that the policy I purchased in FL was no longer valid once I moved to AZ. It was specifically for FL

[Dave Gray]

I got an itemized bill.  Everything on it is crazy.

But one single CT scan cost $24,107.00

[Dave Gray]

OK, so after talking to all the parties, here's what's going on:

The hospital is just charging crazy shit to write it off, essentially.
They just charge whatever crazy shit they want.  $5000 is the high end for the scan that I got.   This hospital billed over 24K.
My insurance company (and presumably all insurance companies) have a "contract" with the hospital, so my bill is discounted $30,000.  ...then, insurance pays their portion (in this case, $3000something.)  I pay the remainder, which is $925ish.

So, it's bullshit books-cooking, it sounds like.